Practice Management News

Prescription Drug Rates Continue to Challenge Cancer Centers

Cancer center leaders identified rising prescription drug rates as the top threat to their program’s growth for the second consecutive year.

Prescription drug rates and cancer centers

Source: Thinkstock

By Jacqueline LaPointe

- Prescription drug rates and the costs of new treatment modalities continued to challenge cancer centers, according to the most recent Trending Now in Cancer Care survey from the Association of Community Cancer Centers (ACCC).

For the second year in a row, respondents from cancer programs identified prescription drug costs as the top threat to future program growth. About 68 percent of respondents cited drug costs as the top threat in 2017.

Prescription drug rates for new and old cancer drugs continue to rise, recent reports revealed. For example, a recent study in the New England Journal of Medicine found that four out of five patients with advanced blood cancer who received CAR-T cells saw their disease progression slow. Over half also saw their lymphomas disappear.

However, CAR-T cell drugs are expensive, totaling $373,000 for a single dose and reaching $475,000 for other brands, WBUR reported. Those costs also do not include pre-drug tests and monitoring and side effect management, which can bring the total costs for drug administration close to $750,000 or more.

Even existing cancer drugs experienced prescription drug rate hikes. CBS News recently uncovered that the price of a 40-year-old treatment for brain tumors and Hodgkin’s lymphoma soared 1,400 percent since 2013 when Bristol-Myers Squib sold the drug to NextSource.

As prescription drug costs continue to plaque cancer programs, respondents in the ACCC survey also identified drugs as the second-ranking opportunity for cost savings, following clinical standardization.

Another high-ranking challenge for cancer centers was physician alignment around service and program goals. Approximately 47 percent of respondents cited this as a major challenge to their program’s growth.

Additionally, cancer centers providers and leaders pinpointed health policy and payment changes as top threats to the future of program growth. The threats included changes in healthcare coverage with 46 percent, fee-for-service reimbursement cuts with 44 percent, and the value-based reimbursement shift with 43 percent.

Despite reimbursement woes and coverage uncertainty, cancer center leaders still intend to expand service lines in the next year to meet the demand for more personalized, patient-centered care. Respondents expect to engage in the following:

• 19 percent of participants are developing and 15 percent plan to develop symptom management clinics

• 19 percent are currently establishing and 13 percent plan to establish symptom management phone triage centers

• 12 percent are creating and 19 percent plan to create high-risk clinics

• 14 percent are developing and 13 percent plan to develop complementary and alternative services

• 12 percent are establishing and 14 percent plan to establish survivorship clinics

Another 20 percent of respondents anticipate opening a specialty pharmacy in the next year. Cancer center providers and administrators believe the pharmacy services will make it easier for patients to acquire medications (91 percent), generate revenue (88 percent), and improve patient education and support (81 percent).

Program leaders are also investing in additional staff to provide additional service lines. Providers and administrators reported investing in the following:

• 18 percent added palliative care physicians in 2017 and 14 percent anticipate adding the role in 2018

• 16 percent employed a palliative care advanced practitioner in 2017 and 15 percent plan to employ one in 2018

• 18 percent added nurse navigators in 2017 and 11 percent to add the role to their team in 2018

• 12 percent employed genetic counselors in 2017 and 13 percent expect to add them in 2018

In addition, cancer programs leaders are either merging or partnering with other healthcare organizations to improve their bottom lines. Three-quarters of cancer programs partnered with a hospital or health system in 2017.

Another 36 percent collaborated with a private oncology practice, while 8 percent partnered with a multispecialty group and 4 percent worked with a national oncology group.

One-half of the cancer program providers and leaders stated that they entered these partnerships to maintain and/or grow their market share.

Increasing alignment with hospitals and physicians was also a top reason for partnerships for one-fourth of the respondents.

Cancer care programs have benefited from the mergers, partnerships, and other collaborations in 2017, the survey stated. Nearly one-half of the participants reported being satisfied with their merger, acquisition, affiliation, or professional services or co-management agreement. Another 21 percent were very satisfied.

Only 10 percent of the respondents stated that they were dissatisfied with their partnership.

ACCC intends for the survey information to help cancer centers thrive in an increasingly competitive environment that is also transitioning to a new payment system.

“From barriers to care to opportunities for cost-savings to benchmarking data to support short- and long-term strategic planning, these survey results highlight our commitment to helping our members thrive—not merely survive—in a tumultuous and ever-changing healthcare environment,” stated ACCC President Mark S. Soberman, MD, MBA, FACS.